Scientific Programme
Sports and Exercise Medicine and Health
IS-MH02 - Magnetic Resonance in Motion: Understanding How Brain, Skeletal Muscle, and Heart Respond to Exercise
Date: 08.07.2026, Time: 11:00 - 12:15, Session Room: SG 1138 (EPFL)
Description
Coordinated physiological responses across brain, skeletal muscle, and heart are central to the widespread health benefits of exercise. Developing an integrative understanding of how these tissues adapt, or fail to adapt, is critical for optimising strategies to enhance human health, performance, and recovery. Advances in magnetic resonance (MR) techniques have transformed our ability to non-invasively, and dynamically, assess metabolic, functional, and structural changes across tissues. This symposium brings together leading researchers applying state-of-the-art MR methods to examine exercise-induced responses in-vivo. Dr Pratt will discuss the value of multi-nuclear MRS and functional MRI for assessing responses of brain energy metabolism, connectivity, and neurovascular function. Dr Hooijmans will highlight the use of phosphorus MR-spectroscopy (³¹P-MRS) to characterise skeletal muscle energetic and functional responses to exercise. Dr Willems will discuss how real-time exercise cardiac MRI, has broad applications for assessing cardiac health across athletic and clinical cohorts. These talks will demonstrate how MR can capture integrated physiological responses to exercise, identify early signs of dysfunction, and inform interventions to enhance performance and support public health. By showcasing complementary MR methods, this symposium will provide valuable insights for researchers and clinicians aiming to better understand and optimise exercise adaptation.
Chair(s)
Jedd Pratt
Manchester Metropolitan University, Department of Sport and Exercise Sciences
United Kingdom
Speaker A
Jedd Pratt
Manchester Metropolitan University, Department of Sport and Exercise Sciences
United Kingdom
Read CVECSS Rimini 2025: IS-MH02
Exercise and the Brain: What Can Magnetic Resonance Tell Us?
Regular physical activity is increasingly recognised as a critical determinant of cognitive function and brain health. We know that even a single bout of exercise can improve cognition, however, the neurobiological mechanisms underpinning these effects are poorly understood. One emerging hypothesis is that exercise induces acute neurometabolic and functional responses in the brain, that when repeated over time, may contribute to longer term adaptations. In this presentation I will discuss the applications of magnetic resonance spectroscopy (MRS) and functional magnetic resonance imaging (fMRI) for non-invasively examining these processes in vivo. Proton and phosphorus MRS (¹H-MRS and ³¹P-MRS) provide an excellent platform for quantifying a range of metabolites involved in brain energy metabolism and neurotransmission. Their use is particularly relevant given increasing evidence that cerebral glucose uptake and metabolism may decrease as exercise intensity increases, suggesting that alternative energy substrates are increasingly relied upon to sustain brain function. A key focus of this talk will be the real-time assessment of brain metabolism during exercise, made possible by the emergence of MR-compatible cycle ergometry. I will present new data showing how a single bout of strenuous exercise transiently alters creatine, glutamine/glutamate, and lactate levels in certain regions of the human brain, and discuss how these changes may reflect dynamic shifts in energy substrate utilisation and neurotransmitter cycling. Looking beyond MRS, I will highlight the complementary role of fMRI techniques, including blood oxygen level–dependent (BOLD) imaging and arterial spin labelling (ASL), in characterising the brain’s functional and neurovascular responses to exercise. These methods can identify regional activation and haemodynamic changes that, when combined with metabolic insights captured by multi-nuclear MRS, provide a multidimensional overview of how the brain responds to physical exertion. Overall, this presentation will deepen understanding of how MRS and fMRI can be applied to study how the brain adapts to exercise, with a particular emphasis on real-time MR taken during physical exertion. Together, these approaches hold exciting potential for elucidating the mechanisms by which exercise confers neurocognitive benefits, and for informing strategies to support brain health across performance and public health settings.
Speaker B
Melissa Hooijmans
Vrije Universiteit Amsterdam, Department of Human Movement Sciences
Netherlands
Read CVECSS Rimini 2025: IS-MH02
Phosphorous Magnetic Resonance Spectroscopy to Assess Skeletal Muscle Function During and After Exercise
Phosphorus magnetic resonance spectroscopy (³¹P-MRS) offers a unique, non-invasive window into skeletal muscle metabolism during exercise stress testing. By measuring changes in phosphorylcreatine, inorganic phosphate, and adenosine triphosphate, ³¹P-MRS enables real-time assessment of energy turnover and intracellular pH dynamics. These data provide valuable insight into mitochondrial function, muscle fibre recruitment, and recovery processes in contexts of both health and disease. Exercise stress protocols, whether intermittent or continuous, help characterise physiological responses to varying workloads, though differences in methodology can affect data interpretation. Advances in spatially resolved ³¹P-MRS and its integration with complementary imaging and physiological techniques now allow detailed mapping of metabolic function across individual muscles. This presentation will discuss what aspects of muscle function can be measured using ³¹P-MRS, how these measurements can be obtained during different modes of exercise testing, and how combining modalities can address important clinical and translational research questions in health and disease.
Speaker C
Tineke Willems
University of Gronigen, Department of Radiology
Netherlands
Read CVECSS Rimini 2025: IS-MH02
Exercise and the Heart: Insights from Cardiac Magnetic Resonance
Exercise imposes unique physiological stress on the cardiovascular system, revealing adaptive and maladaptive mechanisms that remain undetectable at rest. In healthy states, exercise promotes beneficial cardiac remodeling characterised by increased stroke volume, enhanced diastolic filling, and preserved myocardial efficiency. Conversely, pathological states such as coronary artery disease, congenital heart disease, and heart failure with preserved ejection fraction (HFpEF) may unveil subclinical dysfunction that becomes apparent only under physiological stress. This presentation will explore the advantages and challenges of implementing exercise cardiac magnetic resonance (Ex-CMR) with an MR-compatible ergometer in clinical and research settings. Ex-CMR has emerged as a powerful, non-invasive imaging modality to assess cardiac structure, function, and tissue characteristics under physiological stress. Unlike pharmacologic stress testing, Ex-CMR replicates the hemodynamic and neurohormonal environment of true exercise without side effects or contraindications associated with pharmacologic agents. Real-time imaging enables quantitative assessment of biventricular volumes, myocardial strain, and aortic flow during supine cycling, providing superior spatial resolution and reproducibility compared with echocardiography. A key focus of this presentation will be to demonstrate the feasibility and diagnostic value of Ex-CMR across diverse populations, from healthy adults and athletes, to pediatric patients with congenital anomalies and adults with cardiometabolic disease. The added value of Ex-CMR will be illustrated across different cardiac conditions. In congenital heart disease, Ex-CMR provides insight into exercise-induced ischemia and coronary perfusion abnormalities, complementing traditional exercise testing. In older adults and those with HFpEF, Ex-CMR can detect early markers of impaired diastolic reserve and abnormal ventricular–vascular coupling, aiding diagnosis where rest imaging or invasive hemodynamic assessment may be inconclusive. Among athletes, Ex-CMR helps differentiate between physiological hypertrophy from early cardiomyopathy, and supports the establishment of reference ranges for cardiac performance across age and sex. Overall, this presentation will deepen understanding of the clinical and research applications of Ex-CMR. By bridging the gap between physiological exercise testing and advanced imaging, Ex-CMR provides a unified platform to evaluate cardiac adaptation across the continuum of health, disease, and ageing. Wider implementation will depend on improved availability of MR-compatible exercise equipment, standardised protocols, and multi-centre validation studies. Capturing the dynamic cardiac response to exercise, Ex-CMR has the potential to refine diagnosis, enhance risk stratification, and guide personalised management in both clinical and athletic populations.